CCI 59 Modifier Reminders

According to Highmark Medicare Services, Comprehensive Coding Initiative (CCI) edits may be bypassed by reporting modifier 59. Watch out: Incorrect reporting of modifier 59 may get you a CCI denial.

Modifier 59 indicates a distinct procedural service and should only be used to identify procedures or services not normally reported together, but are appropriate under the circumstances. When appropriate, the secondary, additional, or lesser procedure(s) or service(s) must be identified by adding modifier 59. Do not report modifier 59 with the primary procedure.